Pre-Virtual Job Shadow
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1.
What is your school name?
2.
Your Grade Level
3.
Your Age
4.
City of Residence
5.
Gender
-- None --
Female
Male
Other
I do not wish to provide this information
6.
Will you be receiving class and/or career related learning (CRLE) credit for this experience (check all that apply)?
Class Credit
CRLE Credit
7.
Prior to watching the educational videos on this page, how likely are you to pursue a career in healthcare?
0% likely
25% likely
50% likely
75% likely
100% likely
8.
Prior to watching the educational videos on this page, how likely are you to take science related classes?
0% likely
25% likely
50% likely
75% likely
100% likely
9.
Prior to watching the educational videos on this page, how likely are you to consider your health as you make lifestyle decisions?
0% likely
25% likely
50% likely
75% likely
100% likely
10.
Prior to watching the educational videos on this page, how favorable is your opinion of Providence Health & Services?
0% favorable
25% favorable
50% favorable
75% favorable
100% favorable
11.
What is your ethnicity?
Hispanic or Latino
Not Hispanic or Latino
I do not wish to provide this information
12.
What is your race?
AMERICAN INDIAN OR ALASKAN NATIVE- A person having origins in any of the original peoples of North and South America (including Central America), and who maintain tribal affiliation or community attachment.
ASIAN- A person having origins in any of the original poeples of the Far East, Southeast Asia, the Indian subcontinent, including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.
BLACK or AFRICAN AMERICAN- All person having origins in any of the black racial groups of Africa.
NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER- A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
WHITE- All persons having origins in any of the original peoples of Europe, the Middle East or North America.
I do not wish to provide this information.
OTHER- A person identifying with a racial group not listed within the defined selections. Specify: